Provider Demographics
NPI:1922664085
Name:GILLILAND, MORGAN ANDERSON (NP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ANDERSON
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 WILLOW PASS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2325
Mailing Address - Country:US
Mailing Address - Phone:925-849-6633
Mailing Address - Fax:
Practice Address - Street 1:3711 SUNSET LN STE D
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6125
Practice Address - Country:US
Practice Address - Phone:888-990-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95011395363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner